Pro Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRO LAB, LLC

Practice address

3752 Teays Valley Rd Ste 1
Hurricane, WV 25526-9705

Phone

(304) 344-1623

NPI assigned

Dec 30, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Todd R Jones

Title

President

Phone

(304) 344-1623

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1033706569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "CABIN CREEK",
            "state": "WV",
            "postal_code": "250350279",
            "telephone_number": "304-344-1623",
            "fax_number": "304-556-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 TEAYS VALLEY RD STE 1",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269705",
            "telephone_number": "304-344-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-344-1623",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.